Purpose: To evaluate a significance of noninvasive imaging modalities, multi-detector row computed tomographic angiography (MDCTA) and magnetic resonance angiography (MRA) in detection of the cause in patients presenting with subarachnoid or intracranial hemorrhage. Materials and methods: Authors evaluated patients admitted to our hospital between January 2004 and December 2005 who successfully underwent MDCTA or MRA (56 and 54 examinations, respectively). The results were compared with digital subtraction angiography (DSA) or intraoperative findings. The MDCT angiography studies consisted of 0.75 mm slices, time acquisition under 10 seconds. The MRI protocol (1.5T scanner) with 3D time-of-flight MRA (slice thickness 0.8 mm, time acquisition cca 6 min) was used. DSA angiography was limited either to patients without demonstrable source of bleeding to or to those where more information was required. Results: Ninety-seven intracranial aneurysms, two arteriovenous malformations (AVM) and one cerebral sinus thrombosis were identified in 100 patients (101 examinations): 81 of these lesions were responsible for subarachnoid hemorrhage. In cases of negative findings, authors performed DSA in 19 patients (20 examinations). Other 17 patients were evaluated for additional information. Surgery was undertaken directly in 31 and endovascular treatment in 32 patients. The sensitivity in the detection of ruptured intracranial aneurysm was 95.5 % and 92.3 % for MDCTA and MRA, respectively. Conclusion: Both the MDCTA and MRA can replace DSA as the first diagnostic modality in the detection of the cause of subarachnoid hemorrhage. But MRA increases diagnostic challenge and appropriate selection of the patients is important. DSA remains the important technique for investigation of subarachnoid hemorrhage in inconclusive findings of the noninvasive methods.

        Key words: subarachnoid hemorrhage – intracranial aneurysm – multidetector computerized tomography angiography – magnetic resonance angiography